Tag Archives: brain rehab

Tinnitus, or ringing in the ears, is an exceptionally common problem. As many as 2 million Americans experience this on a daily basis. It can range from very minor to annoying to debilitating.

Tinnitus is often associated with hearing loss. Prolonged exposure to loud noises is the most common cause of hearing loss. It is this loss of hearing that is actually causing the tinnitus. Say what? Hearing loss actually causes people to hear sounds that don’t really exist? Yes!

People often describe tinnitus as ringing in the ears. However, the list of sounds that are considered tinnitus is very long. Other sounds that people might perceive include ticking, clicking, whooshing and buzzing to name a few.

Recent research, published online in the journal Proceedings of the National Academy of Sciences, suggest several new approaches to treatment, including retraining the brain, and new avenues for developing drugs to suppress the ringing.

As a chiropractic neurologist the above statement about retraining the brain got my attention. This is something that is near and dear to the heart of all chiropractic neurologists. We use techniques that retrain the brain every day. We use these techniques to help people with a wide variety of conditions ranging from anxiety to muscular imbalances and pain.

Traditionally, patients with tinnitus are told the problem stems from damaged hair cells inside of the ear. They are told it is these hair cells that are sending the wrong signals into the brain which interprets them as noise. Turns out, this is not true.

Because each hair cell is tuned to a different frequency, damaged or lost cells leave a gap in hearing, typically a specific frequency and anything higher in pitch. It is this gap which causes problems for the brain.

Chiropractic neurologists have been saying for a very long time that ringing in the ears is actually brain based. This new research supports this assertion. Below is information from coauthor of the recent study Shaowen Bao, adjunct assistant professor in the Helen Wills Neuroscience Institute at UC Berkeley

Experiments in the past few years have shown that the ringing doesn’t originate in the inner ear, though, but rather in regions of the brain — including the auditory cortex — that receives input from the ear.

Bao’s experiments in rats with induced hearing loss explain why the neurons in the auditory cortex generate these phantom perceptions. They showed that neurons that have lost sensory input from the ear become more excitable and fire spontaneously, primarily because these nerves have “homeostatic” mechanisms to keep their overall firing rate constant no matter what.

“With the loss of hearing, you have phantom sounds,” said Bao, who himself has tinnitus. In this respect, tinnitus resembles phantom limb pain experienced by many amputees. (From sciencedaily.com)

The neurons that have lost sensory input in the brain are the neurons that are responsible for the perceived noise that people hear. These neurons have undergone a process called transneural degeneration. To stabilize these neurons they need more input. But because they cannot receive it from the hair cells in the ear that are damaged, other areas of the auditory cortex must take over. This retraining of the brain takes time, but if performed diligently, the results can be phenomenal.

We know this is a possibility because the brain is plastic. That is, it changes in response to the stress and environmental input it receives. When a finger is amputated, for example, the region of the brain receiving input from that finger may start handling input from neighboring fingers.

Drug therapy is aimed at increasing the levels of the neurotransmitter GABA in the brain. GABA is the primary inhibitory neurotransmitter. In order to slow down the firing rate of these over excited cells, we must increase the levels of this inhibitory neurotransmitter. The good news is there are lots of natural therapies that work to raise GABA levels or drive GABA receptors in the brain.

One way is to use the amino acid taurine. I use it frequently. Another is a product called phenibut (Phen-i-bute). It is a natural GABA derivative that crosses the blood brain barrier and binds to GABA receptors. I also use this frequently in my practice. These supplements, however, I believe are temporary solutions. The permanent solution is to retrain the brain.

Tinnitus is a complicated and elusive condition, but we appear to be headed in the right direction in terms of research. Always remember, the brain holds the key!

Exercise has long been known to increase brain function. Most of the research, however, focused on the benefits of purely cardiovascular exercises like running. New research shows that weight training has the same effect.

Conventional wisdom has stated that the benefits of cardiovascular exercise on brain function was from the significant increase in blood flow to the brain during aerobic type exercises. It was concluded that because weight training didn’t cause this to happen for extended periods of time, it would not have the same benefit.

The creation of new brain cells, or neurogenesis, is thought to be dependent on a spike of blood flow to the brain. In fact, running and other aerobic exercises have been shown to increase neuron production in the areas of the brain associated with memory and thinking in both mice and humans. However, this was thought not to apply to resistance training. That is changing.

“In a study presented at the annual meeting of the Society for Neuroscience in November, researchers from Brazil secured weights to the tails of a group of rats and had them climb a ladder five sessions a week. Other rats on the same schedule ran on a treadmill, and a third group just sat around. After eight weeks, the running rats had much higher levels of brain-derived neurotrophic factor (B.D.N.F.), a growth factor that is thought to help spark neurogenesis, than the sedentary rats. So did the rats with weights tied to their tails. The weight-­bearing rats, like the runners, did well on tests of rodent learning and memory, like rapidly negotiating a water maze. Both endurance and weight training seemed to make the rats smarter.” (From The NY Times)

A similar study from Japan at the same conference came to the same conclusions.

“The animals that were assigned to the loaded wheels showed significantly increased levels of gene activity and B.D.N.F. levels within their brains. The higher the workload the animals managed to complete, the greater the genetic activity within their brains.” (From The NY Times)

The genetic activity is important. That’s precisely how the human brain adapts. It changes the expression of certain genes in order to respond to certain environmental input. That input may be in the form of exercise like weight training or it may be more cognitively based like learning to play the piano. Whatever the input may be, the brain changes in response to the activity being performed. This is a phenomenon called plasticity. And the brain remains plastic our entire lives! That means it can change right up to the day we die.

Just how does this resistance training increase brain function? No one knows for sure, but there are theories. The researchers propose that because weight training reduces many cardiovascular risk factors and does increase the strength of the heart it may also help the brain through similar mechanisms that aerobic exercise does.

I have another theory. Ninety percent, yes that’s 90%, of the input that comes into our brains during any given day comes from the receptors in our muscles and joints. That means that if we take into account all of the sensory input that our brains receive during the day – light, sound, touch, smell, proprioception – a full 90% of that input is coming from our muscles and joints. If the body requires that much input from our musculoskeletal system it must be important, right? It is. This input keeps the brain functioning normally and maintains the health of just about every type of neuron in the brain.

Resistance training makes this input more efficient. By training the muscles with weights they send more regulatory information to the brain and you also increase the amount of information coming from the joints. The stronger your muscles the more force is applied through your joints. This combination is a winning one in terms of brain function.

The best type of exercise program is one that includes both cardiovascular and resistance type training. People are often hesitant to start a weight training program because of lack of knowledge on how to properly do it. If you are concerned hire a knowledgeable trainer to show you how to do it. The benefits will far outweigh your hesitance to start.

In the study of neurology, there are many theories and formulas that can be applied in order to better help our understanding of how we as humans experience the world around us. Scientists, researchers and other doctors break them down, analyze them and apply them to different areas of the brain, mostly for academic value. That is extremely valuable, especially for me as a functional neurologist. While helpful for me, this is usually not the case for many of you. One of the most common questions I get is “How can I better understand the way my brain functions so I can feel better?”

There is one principle that applies to the entire brain that is very easy to understand and is indispensable for me when considering my treatments. It is also very simple; input equals output. That’s it. And it really is as simple as it sounds.

Our brains are completely dependent upon the input coming in from all around us to generate its output. Let me give you a simple example of correct input resulting in correct output and then just the opposite. Picture yourself at a restaurant and you are ordering a wonderful organic, grass-fed New York strip steak. When you place your order the waiter asks, “How would you like that done?” You reply, “Medium, please.” You responded appropriately because the input (the waiter’s question) was interpreted by your brain correctly and it quickly formed the correct output (your response to his question). But what if the scenario unfolded as follows; the waiter asks the same question, but you hear, “Would you like a bun?” You might reply, “No thank you,” but of course the waiter would look at you funny because that is not the answer to his question. The problem in the second scenario is that the input was interpreted incorrectly, so your brain had no choice but to formulate incorrect output.

This is a very simple set of circumstances, but in fact, this is happening millions of times per day in our own brains. And input comes from everywhere! Input comes from the outside world in the form of hearing, sight, touch, taste and smell among others. This is called external input. Input is also internally generated. This input comes from within the brain from other circuits that communicate with each other to maintain the high output of the human brain.

Both internally and externally generated input is critical. In functional neurology, we use a combination of these two inputs to change the way the brain fires. First we establish where the problem is. A person might say they have headaches, high blood pressure or depression, all of which could be from aberrant output of the brain. The symptoms are being caused from this aberrant output, but as illustrated earlier, the brain is actually just responding or interpreting the input it is receiving incorrectly. Once we discover the part of the brain that is not working correctly, we recommend specific exercises to retrain the brain.

It is through these corrective exercises that we are able to change the input, which changes the output and reduces the symptoms of many conditions. It is a cutting edge treatment for many conditions and is gaining momentum as research mounts on brain function.